Doctor of Philosophy

dissertationCongenital heart defects are classes of birth defects that affect the structure and function of the heart. These defects are attributed to the abnormal or incomplete development of a fetal heart during the first few weeks following conception. The overall detection rate of congenital heart defects during routine prenatal examination is low. This is attributed to the insufficient number of trained personnel in many local health centers where many cases of congenital heart defects go undetected. This dissertation presents a system to identify congenital heart defects to improve pregnancy outcomes and increase their detection rates. The system was developed and its performance assessed in identifying the presence of ventricular defects (congenital heart defects that affect the size of the ventricles) using four-dimensional fetal chocardiographic images. The designed system consists of three components: 1) a fetal heart location estimation component, 2) a fetal heart chamber segmentation component, and 3) a detection component that detects congenital heart defects from the segmented chambers. The location estimation component is used to isolate a fetal heart in any four-dimensional fetal echocardiographic image. It uses a hybrid region of interest extraction method that is robust to speckle noise degradation inherent in all ultrasound images. The location estimation method's performance was analyzed on 130 four-dimensional fetal echocardiographic images by comparison with manually identified fetal heart region of interest. The location estimation method showed good agreement with the manually identified standard using four quantitative indexes: Jaccard index, Sørenson-Dice index, Sensitivity index and Specificity index. The average values of these indexes were measured at 80.70%, 89.19%, 91.04%, and 99.17%, respectively. The fetal heart chamber segmentation component uses velocity vector field estimates computed on frames contained in a four-dimensional image to identify the fetal heart chambers. The velocity vector fields are computed using a histogram-based optical flow technique which is formulated on local image characteristics to reduces the effect of speckle noise and nonuniform echogenicity on the velocity vector field estimates. Features based on the velocity vector field estimates, voxel brightness/intensity values, and voxel Cartesian coordinate positions were extracted and used with kernel k-means algorithm to identify the individual chambers. The segmentation method's performance was evaluated on 130 images from 31 patients by comparing the segmentation results with manually identified fetal heart chambers. Evaluation was based on the Sørenson-Dice index, the absolute volume difference and the Hausdorff distance, with each resulting in per patient average values of 69.92%, 22.08%, and 2.82 mm, respectively. The detection component uses the volumes of the identified fetal heart chambers to flag the possible occurrence of hypoplastic left heart syndrome, a type of congenital heart defect. An empirical volume threshold defined on the relative ratio of adjacent fetal heart chamber volumes obtained manually is used in the detection process. The performance of the detection procedure was assessed by comparison with a set of images with confirmed diagnosis of hypoplastic left heart syndrome and a control group of normal fetal hearts. Of the 130 images considered 18 of 20 (90%) fetal hearts were correctly detected as having hypoplastic left heart syndrome and 84 of 110 (76.36%) fetal hearts were correctly detected as normal in the control group. The results show that the detection system performs better than the overall detection rate for congenital heart defect which is reported to be between 30% and 60%

Smoothing of ultrasound images using a new selective average filter

Ultrasound images are strongly affected by speckle noise making visual and computational analysis of the structures more difficult. Usually, the interference caused by this kind of noise reduces the efficiency of extraction and interpretation of the structural features of interest. In order to overcome this problem, a new method of selective smoothing based on average filtering and the radiation intensity of the image pixels is proposed. The main idea of this new method is to identify the pixels belonging to the borders of the structures of interest in the image, and then apply a reduced smoothing to these pixels, whilst applying more intense smoothing to the remaining pixels. Experimental tests were conducted using synthetic ultrasound images with speckle noisy added and real ultrasound images from the female pelvic cavity. The new smoothing method is able to perform selective smoothing in the input images, enhancing the transitions between the different structures presented. The results achieved are promising, as the evaluation analysis performed shows that the developed method is more efficient in removing speckle noise from the ultrasound images compared to other current methods. This improvement is because it is able to adapt the filtering process according to the image contents, thus avoiding the loss of any relevant structural features in the input images

Ultrasound Signal Processing: From Models to Deep Learning

Medical ultrasound imaging relies heavily on high-quality signal processing algorithms to provide reliable and interpretable image reconstructions. Hand-crafted reconstruction methods, often based on approximations of the underlying measurement model, are useful in practice, but notoriously fall behind in terms of image quality. More sophisticated solutions, based on statistical modelling, careful parameter tuning, or through increased model complexity, can be sensitive to different environments. Recently, deep learning based methods have gained popularity, which are optimized in a data-driven fashion. These model-agnostic methods often rely on generic model structures, and require vast training data to converge to a robust solution. A relatively new paradigm combines the power of the two: leveraging data-driven deep learning, as well as exploiting domain knowledge. These model-based solutions yield high robustness, and require less trainable parameters and training data than conventional neural networks. In this work we provide an overview of these methods from the recent literature, and discuss a wide variety of ultrasound applications. We aim to inspire the reader to further research in this area, and to address the opportunities within the field of ultrasound signal processing. We conclude with a future perspective on these model-based deep learning techniques for medical ultrasound applications

Image Restoration for Remote Sensing: Overview and Toolbox

Remote sensing provides valuable information about objects or areas from a distance in either active (e.g., RADAR and LiDAR) or passive (e.g., multispectral and hyperspectral) modes. The quality of data acquired by remotely sensed imaging sensors (both active and passive) is often degraded by a variety of noise types and artifacts. Image restoration, which is a vibrant field of research in the remote sensing community, is the task of recovering the true unknown image from the degraded observed image. Each imaging sensor induces unique noise types and artifacts into the observed image. This fact has led to the expansion of restoration techniques in different paths according to each sensor type. This review paper brings together the advances of image restoration techniques with particular focuses on synthetic aperture radar and hyperspectral images as the most active sub-fields of image restoration in the remote sensing community. We, therefore, provide a comprehensive, discipline-specific starting point for researchers at different levels (i.e., students, researchers, and senior researchers) willing to investigate the vibrant topic of data restoration by supplying sufficient detail and references. Additionally, this review paper accompanies a toolbox to provide a platform to encourage interested students and researchers in the field to further explore the restoration techniques and fast-forward the community. The toolboxes are provided in https://github.com/ImageRestorationToolbox.Comment: This paper is under review in GRS

Basic Science to Clinical Research: Segmentation of Ultrasound and Modelling in Clinical Informatics

The world of basic science is a world of minutia; it boils down to improving even a fraction of a percent over the baseline standard. It is a domain of peer reviewed fractions of seconds and the world of squeezing every last ounce of efficiency from a processor, a storage medium, or an algorithm. The field of health data is based on extracting knowledge from segments of data that may improve some clinical process or practice guideline to improve the time and quality of care. Clinical informatics and knowledge translation provide this information in order to reveal insights to the world of improving patient treatments, regimens, and overall outcomes. In my world of minutia, or basic science, the movement of blood served an integral role. The novel detection of sound reverberations map out the landscape for my research. I have applied my algorithms to the various anatomical structures of the heart and artery system. This serves as a basis for segmentation, active contouring, and shape priors. The algorithms presented, leverage novel applications in segmentation by using anatomical features of the heart for shape priors and the integration of optical flow models to improve tracking. The presented techniques show improvements over traditional methods in the estimation of left ventricular size and function, along with plaque estimation in the carotid artery. In my clinical world of data understanding, I have endeavoured to decipher trends in Alzheimer’s disease, Sepsis of hospital patients, and the burden of Melanoma using mathematical modelling methods. The use of decision trees, Markov models, and various clustering techniques provide insights into data sets that are otherwise hidden. Finally, I demonstrate how efficient data capture from providers can achieve rapid results and actionable information on patient medical records. This culminated in generating studies on the burden of illness and their associated costs. A selection of published works from my research in the world of basic sciences to clinical informatics has been included in this thesis to detail my transition. This is my journey from one contented realm to a turbulent one